In two studies unveiled at the 2010 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), researchers examined the relationship between folate levels in pregnancy and the risk of having an asthmatic child, along with the effectiveness of avoiding food allergens during pregnancy in high risk families.

Folate Levels

One study found that children born to mothers with higher folate levels during pregnancy had an increased risk of asthma at age 3.

Taking their sample from the Norwegian Mother and Child Cohort Study, researchers measured folate levels during the second trimester of pregnancy in the plasma of 507 mothers of children with asthma at age 3. Researchers also measured folate levels in 1,455 mothers of controls.

“Norway provides an excellent opportunity to address the question of possible deleterious consequences of high folate intake during pregnancy because the food supply is not fortified,” explained Stephanie J. London, MD, DrPH, one of the study authors.

Children born to mothers who had plasma folate levels in the top 20% had an increased risk of asthma at age 3 in comparison to those mothers who had the lowest levels. The researchers also found a trend of linear increase, meaning that when looking across the sample, as the mother’s plasma folate level increased so did the risk of asthma in the child.

“These findings based on an objective marker of folate status and follow-up to age 3 extend our previous research based on reported supplement use and outcomes to 18 months. The next step is to follow-up these children to an age when asthma can be more reliably diagnosed,” added London.

Food Allergens

In the other study, researchers at Royal Prince Alfred Hospital in Australia looked at how effective it was for pregnant mothers of food allergic children to follow dietary and environmental avoidance measures in an effort to prevent their subsequent children from developing food allergies.

“The avoidance advice encompassed the third trimester of pregnancy, during breast feeding and into the second year of life. Particular emphasis was placed on nut avoidance and to a lesser extent egg and milk,” said Velencia Soutter, MD, lead author of the study.

The siblings of 274 cases were evaluated for symptoms of allergic disease and given a skin prick test to measure allergen sensitization at 18 and 36 months. The siblings were placed in an ‘avoidance’ or ‘no avoidance’ group depending on whether their mother chose to follow the dietary advice.

Those in the avoidance group had a significantly lower occurrence of peanut and egg sensitization at both 18 and 36 months. At 36 months, peanut sensitization was only present in 16% of the siblings in the avoidance group, compared with 52% in the no avoidance group. At that same age, egg sensitization was present in 34% in the avoidance group versus 75% in the no avoidance group.

In addition, siblings in the avoidance group were less likely to develop symptoms of asthma at both ages. Only 11% in the avoidance group had developed asthma symptoms at 36 months, while 43% in the no avoidance group did.

“Early allergen avoidance can prevent the development of food allergies and may have an impact on later development of allergic disease,” commented Soutter.

Rates of dust mite sensitization and eczema were lower in the avoidance group at 18 months, but were not significantly different among the two groups at 36 months.

The AAAAI (www.aaaai.org) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has nearly 6,500 members in the United States, Canada and 60 other countries. To find an allergist/immunologist in your area, visit www.aaaai.org/physref.

Editor’s notes:

These studies were presented during the 2010 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) on February 26-March 2 in New Orleans. However, they do not necessarily reflect the policies or the opinions of the AAAAI.

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